Clinical spectrum of oral candidosis and its role in HIV-infected patients.

Oral candidosis is a very frequent diseased state occurring mainly together with severe underlying disease. Clinical manifestation is variable. One can distinguish between oral thrush, denture stomatitis, angular cheilitis, leukoplakia and midline glossitis. Nowadays oral candidosis is also important in connection with HIV-infection. Here the clinical spectrum does not seem to be totally different. Apart from oral thrush (or pseudomembraneous type) a chronic atrophic type, a chronic hyperplastic type, papillary hyperplasia and angular cheilitis are distinguished. Oral candidosis is the most frequent opportunistic infection in HIV-infected patients. Frequency of overt disease is linked to the T4/T8 ratio. In patients with AIDS-related complex oral candidosis seems to be indicative of rapid progression. Candida albicans is the prevailing microorganism. There is, however, a change of biotypes during the course of HIV-infection. There seems to be a selection of certain phenotypes as can be judged from the increasing resistance to 5-fluorocytosine.